Plaque Psoriasis

Last reviewed by Dr.Mary on August 7th, 2018.

What is Plaque Psoriasis?

Plaque Psoriasis is a fairly common disease of the skin that influences the lifecycle of the cells of the skin. This disease causes the cells to increase very quickly on the skin surface, causing thick silvery scales as well as itchy, red, dry patches of plaque which are at sometimes painful.


This medical condition is a long-lasting chronic disease. The individual can have times when the psoriasis symptoms get better or go into total remission which alternates with times when psoriasis worsens.

Plaque Psoriasis Symptoms

Psoriasis signs and symptoms may vary from individual to individual but can contain one or several of the below:

  • Burning, itching or soreness
  • Patches of red skin covered with scales which are silvery
  • Small scaly spots – usually seen in children
  • Cracked, dry skin which can bleed
  • Swollen as well as stiff joints
  • Pitted, ridged and thickening nails

Most of the forms of psoriasis have cycles, flaring up for several weeks or even months, then getting better for a while or going into total remission. In the majority of cases, the disease ultimately will return.

There are numerous forms of psoriasis including:

Plaque Psoriasis

This is the most frequent type and causes raised, red, dry skin lesions or plaques covered over with scales which are silvery. The plaques may be itchy, painful as well as can happen anyplace on the body, including the genitals as well as the soft mouth tissues.

Nail psoriasis

This affects toenails as well as fingernails, causing abnormal growth of the nail, with pitting, and discolouration. Nails can become loose and in some cases come apart from the bed of the nail.

Scalp psoriasis

Develops in the scalp and appears as itchy, red areas with scales which are silvery-white.

Inverse psoriasis

Affects typically the skin in the groin, armpits, around the genitals, under breasts and causes patches which are smooth and have inflamed red skin. It is most common in individuals who are overweight and is made worse by sweating as well as friction.

Guttate psoriasis

Normally affects those individuals less than 30 years of age as well as is generally activated by infection, for instance, strep throat. It is marked by “water-drop-shaped”, small sores on the trunk, legs, scalp and arms. The sores are covered over with a fine scale and are not as bulky as normal plaque is. You can have a solo outbreak which clears up without treatment, or you can have episodes which are repetitive.

Pustular psoriasis

An uncommon type of psoriasis which may occur in patches which are widespread or in small spots on the fingertips, hands, and feet. It usually builds up rapidly, with blisters which are pus-filled emerging in a matter of hours after the skin becomes tender as well as red. The blisters will dry up in a couple of days but can re-emerge in a few days or weeks. General pustular psoriasis may also cause severe itching, chills, fatigue as well as fever.

Erythrodermic psoriasis

The very least common form of psoriasis, this can cover the complete body amid a peeling, red rash which can burn or itch intensely.

Psoriatic arthritis

Additional to scaly, inflamed skin, this type of psoriasis causes discoloured, pitted nails as well as swollen and painful joints which are characteristic of arthritis.

Plaque Psoriasis Causes

The causes of psoriasis are associated with the immune system. To be more specific, a kind of white blood cell known as T cell. Usually, T cells go through the body to find and battle foreign matter, such as bacteria or viruses. But with psoriasis, the T cells attack the skin which is healthy.

T cells which are overactive can activate additional immune response including a boost in other white blood cells which enter the epidermis as well as causes dilation of blood vessels. These changes cause an enhanced creation of both good skin cells as well as T cells and other white blood cells. This causes a continuing cycle of fresh skin cells moving to the topmost covering of skin too fast – in days instead of weeks. White blood cells and skin that is dead can not slough off rapidly enough and therefore build up as scaly, thick areas on the surface of the skin. This usually does not stop unless the cycle is interrupted by treatment.

Just why T cells malfunction in individuals with psoriasis is not completely clear, although scientists believe environmental and genetic features both take part in.

Psoriasis normally begins or get worse because of an activator which the patient can perhaps identify and avoid. Features which can activate psoriasis include:

  • Damage to the skin, for instance, a scrape or a cut, bug bite, or a severe sunburn
  • Infections such as thrush or strep throat
  • Stress
  • Smoking
  • Cold weather
  • Alcohol consumption which is heavy
  • Some drugs – including lithium which is used for bipolar disorder; medications for high blood pressure such as beta blockers; iodides; and antimalarial drugs.

Any person can develop psoriasis, but there are factors which increase the odds of developing this disease. They include:

Family history

The most significant risk factor is a family history of this disease. Almost 1 in 3 individuals with psoriasis usually have a close relative who has the same condition.

Other medical problems

Individuals with HIV are more likely to have psoriasis than those with healthy systems of immunity. Young adults as well as children with infections which are recurring, especially strep throat, can also be at increased risk.

Stress

Stress can impact the immune system, and high-stress levels can increase the risk of psoriasis.

Obesity

Excess weight can increase the risk of inverse psoriasis. Additionally, plaques associated with all form of psoriasis often occur in folds or skin creases.

Smoking

Tobacco smoking not only increases the risk of psoriasis but may increase the disease’s severity. Smoking can as well play a role in the initial beginning of the disease.

Depending on the location as well as type of psoriasis and how widespread is the disease, psoriasis can develop complications. These can include:

  • Fluid and electrolyte imbalance in cases of severe pustular psoriasis
  • Thickened skin and bacterial skin infections developed because of scratching to relieve severe itching
  • Depression
  • Low self-esteem
  • Stress
  • Social isolation
  • Anxiety

Plaque Psoriasis Treatment

The aim of the treatments of psoriasis:

  • Interrupt the cycle which reduces the inflammation and plaque formation
  • Remove the scales and smooth skin using topical treatments

Psoriasis treatments are divided into 3 main types:

  • Light therapy
  • Oral medication
  • Topical treatments

Topical treatments

Creams and ointments which are used alone can treat mild to modest psoriasis. If the disease is worse, creams are normally joined with oral medications or light therapy. These topical treatments can include:

  • Vitamin D analogues
  • Topical corticosteroids
  • Anthralin
  • Topical retinoids
  • Salicylic acid
  • Calcineurin inhibitors
  • Moisturizers
  • Coal tar

Light therapy or phototherapy

This treatment uses artificial ultraviolet or natural light. The easiest and simplest form of phototherapy involves the exposing of the skin to controlled amounts of natural sunlight.

  • Sunlight
  • Narrowband UVB therapy
  • UVB phototherapy
  • Ecimer laser
  • Photochemotherapy or psoralen plus ultraviolet A or PUVA
  • Combination light therapy

Injected or oral medications

This is normally for severe psoriasis or psoriasis which is resistant to other types of treatment. There are some side effects, so these medications are used only for brief periods of time.

  • Retinoids
  • Methotrexate
  • Cyclosporine
  • Hydroxyurea
  • Immunomodulatory drugs (biologics)

Although physicians choose treatments which are based on severity, type of the disease as well as the areas of affected skin, the customary approach is to begin with the mildest methods of treatments – ultraviolet light therapy and topical creams – and then move to stronger treatments as needed. The aim is to determine the most favorable method to use in slowing the turnover of cells with the fewest side effects.

Plaque Psoriasis Pictures

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